{"id":13547,"date":"2018-10-17T11:00:02","date_gmt":"2018-10-17T15:00:02","guid":{"rendered":"http:\/\/lifeinsurance-orleans.ca\/Life-Insurance-Blog\/gender-wage-gap-medicine\/"},"modified":"2019-04-30T22:05:42","modified_gmt":"2019-05-01T02:05:42","slug":"why-is-there-a-gender-wage-gap-in-canadian-medicine","status":"publish","type":"post","link":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/2018\/10\/17\/why-is-there-a-gender-wage-gap-in-canadian-medicine\/","title":{"rendered":"Why is there a gender wage gap in Canadian medicine?"},"content":{"rendered":"
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Pay gaps within specialties <\/strong><\/h2>\n

Even when women opt to work in surgery, one of the higher-paying specialties, they are often nudged into the lower-paying end of it, says Baxter. \u201cYou\u2019re always encouraged to do breast surgery,\u201d she says. And perhaps if not encouraged, expected. \u201cWhen you talk to women residents and you ask, \u2018What are you interested in?\u2019 they\u2019re quite aware that, as a woman practising in general surgery, they\u2019re likely to preferentially get more referrals for breast issues than some of the other stuff,\u201d says David Urbach, a general surgeon at Women\u2019s College Hospital in Toronto. \u201cI definitely see a lot of women general surgeons end up doing a disproportionate amount of breast surgery. And overall, breast surgery is not quite as lucrative\u2014the time required to do the procedures, but also the consultations, which take a lot longer than the consultations to assess gall bladders and hernias.\u201d<\/p>\n

Female surgeons receive the majority of referrals for mastalgia, says Lesley Barron, a general surgeon who works in Georgetown, Ont., and recently wrote<\/a> about the gender pay gap. Mastalgia is the medical term for breast pain, and it doesn\u2019t usually require surgery. \u201cIt\u2019s basically counselling patients, going over their imaging results, and spending a lot of time hand-holding,\u201d says Barron. \u201cI\u2019m not saying that\u2019s something I shouldn\u2019t be doing, it\u2019s just if I have to see 50 mastalgia patients to book one operative case, it gets very frustrating.\u201d<\/p>\n

Plus, surgeries that are often specific to women\u2014and to female surgeons\u2014can pay less. The procedure to correct rectal prolapse, a condition affecting primarily women in which the rectum slides out through the anus, has become something of a niche for female colorectal surgeons, says Nancy Baxter. It pays significantly less\u2014$356\u2014than some procedures that she says require less skill and experience, such as a laparoscopic right hemicolectomy (removal of the right side of the bowel for colon cancer), which pays $1,000. Baxter recently conducted a study that compared how much men and women are paid per hour in the OR. \u201cWe\u2019re interrogating the fee-for-service system in operative remuneration,\u201d she says. \u201cOur hypothesis is that it does not result in equity.\u201d<\/p>\n

Cathy Faulds, a family physician in London, Ont., echoes this notion with respect to primary care. Fee-for-service, \u201crewards the turnstile,\u201d she says, and points to research which shows that female family doctors spend more time<\/a> with patients and deal with more issues in a single visit than males do. \u201cWhen you look at those fee codes, they are directed toward the number of patients that you see. They don\u2019t reward the quality of care\u2014[provided by] men or women\u2014they don\u2019t reward the comprehensiveness of care.\u201d Faulds\u2019s husband also worked as a family physician, and at one point, they split a practice of 5,000 patients. \u201cI saw the patients who had complex pain, mental health issues, marital dysfunction, child abuse, chronic pelvic pain,\u201d she says. \u201cMy husband sutured people, looked after myocardial infarctions, fixed their broken bones. Very procedural, and higher paid items than what I saw.\u201d<\/p>\n

In Ontario, many primary care doctors receive a lump sum per patient per year to provide a basket of services. This system, known as capitation, is an example of the kind of alternative payment plan that Faulds says helps to take pressure off family doctors, and perhaps especially the women among them, because it means they are not paid by volume of visits. But the OMA\u2019s research shows a gender wage difference in the capitated model of family medicine too, says Alam. And this may be a factor of women spending more time with patients as well. As David Schieck points out, capitation also rewards volume: the more patients on your roster, the higher your pay.<\/p>\n

Schieck is a primary care doctor who works on a family health team in Guelph, Ont. He has a roster of 1,500 patients. His wife, who works in the same clinic, has about 1,000. \u201cShe spends just as much time at her job as I do,\u201d he says. \u201cShe puts in the same amount of hours and does all the same sort of work.\u201d What\u2019s different, though, is the length of time they each spend with patients. While Schieck thinks he averages 15 to 20 minutes a visit, his wife spends anywhere from 20 to 30.<\/p>\n

A 2017 study<\/a> on primary care in British Columbia found that \u201cfemale physicians earn less annually and have smaller practices and fewer annual patient contacts, compared to their male counterparts.\u201d These gaps were bigger than expected, say the authors, given data from the 2014 National Physician Survey<\/a> which reported \u201conly a small difference (3.21 patient care hours) in weekly work hours between male and female primary care physicians.\u201d<\/p>\n

\u201cIf we had more aspects of our compensation that reflected pay for quality outcomes, a little bit better pay for time spent with patients, a little bit better pay that reflected complexity, I think you would start to address some of the areas where female physicians may do a little bit better than male physicians,\u201d says Schieck. \u201cAnd that may be a start to addressing some of the inequities in compensation that I think probably do exist between male and female physicians.\u201d<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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Many say a gender wage gap should not exist in Canadian medicine, where the system is mostly fee-for-service. Others say the system is part of the problem.<\/p>\n

The post Why is there a gender wage gap in Canadian medicine?<\/a> appeared first on Healthy Debate<\/a>.<\/p>\n<\/div>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[],"tags":[],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/posts\/13547"}],"collection":[{"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/comments?post=13547"}],"version-history":[{"count":4,"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/posts\/13547\/revisions"}],"predecessor-version":[{"id":14734,"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/posts\/13547\/revisions\/14734"}],"wp:attachment":[{"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/media?parent=13547"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/categories?post=13547"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/wp-json\/wp\/v2\/tags?post=13547"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}